SUPRACONDYLAR FRACTURE OF HUMERUS

 

 

Definition of Supracondylar fracture of Humerus:

 

Fracture of the humerus just above the condyle is known as supra-condylar fracture.

          It is common in children but occasionally in adult.

 

 

 

Causes of Supracondylar fracture of Humerus:

 

          It is caused by direct or indirect violence.-

1.    Direct violence:

a.    By direct hit.

 

2.    Indirect violence:

a). Fall on outstreched hand.

b). Fall from height.

c). Road Traffic Accident.

d). During play.

 

 

Types of Supracondylar fracture of Humerus:

 

 

          Mainly two types-

                    i). Flexion-20%.

                    ii). Extension 80%.

 

 

Clinical features of Supracondylar fracture of Humerus:

 

1.    History of trauma.

2.    Pain.

3.    Swelling arround the affected joint.

4.    Tenderness at the lower end of the affected humerus.

5.    Inability to move.

6.    Deformity or abnormal shape.

7.    Displacement may be palpable.

8.    X-ray to confirm diagnosis.

 

 

Management of Supracondylar fracture of Humerus:

 

A.  Diagnosis and assessment:

 

1.    History of trauma is to be taken.

2.    Examine the local soft tissue for injury.

3.    Pulse test- radial pulse present or not.

4.    Nerve test-

i). In case of median nerve injury loss of sensation of the index and middle finger. pointing index sign is present.

ii). In case of radial nerve injury wrist dropped is present.

iii). In case of ulner nerve injury loss of sensation in little finger.

 

 

B. Medication:

1.    Analgesic is to be given to reduce pain. like Diclofenac sodium.

2.    Sedative is to be given e.g diazepum.

3.    Antibiotic is to be given to prevent infection like- Cloxacillin & amoxacillin etc.

4.    In case of external injury the patient is to be immobilized.

 

C. Specific treatment:

Reduction and immobilization by plaster cast or long arm plaster under G/A.

          If there is huge swelling and reduction is not possible then immobilization by long arm posterior cast.

 

 

 

Complication of Supracondylar fracture of Humerus:

 

A.  Immediate complication:

1.    Compression of the brachial artery.

2.    Complete injury of brachial artery.

3.    Incomplete injury of the brachial artery.

4.    Thrombosis of artery.

5.    Volkmann’s ischemia.

6.    Nerve injury- Median ulner nerve.

 
B.  Late complication:

1.    Volkmann’s ischemic contracture.

2.    Mal union.

3.    Deformity.

4.    Stiffness of the elbow joint.

5.    Myositis ossifications.

6.    Tardy nerve palsy.